Facial neurosis: objective and far-fetched reasons

Often you can meet people with an interesting facial expression: it is asymmetrical, as if distorted, emotionless, perhaps accompanied by small muscle twitches.
All these signs are united by a common name - facial neurosis. This condition can have a different nature of occurrence and is provoked by both objective reasons and factors of a psychogenic nature.

Unusual sensations

It happens that a person can feel phenomena in the face and head that are unusual for the usual state. They are called paresthesias and are manifested by the following symptoms:

• tingling;
• burning;
• "goosebumps"
• numbness;
• itching and rashes.

Often facial paresthesias have an organic basis and become a sign of the disease:

• neuritis, neuralgia of the cranial nerves;
• multiple sclerosis;
• stroke and other circulatory disorders in the brain;
• shingles;
• migraine;
• diabetes;
• epilepsy;
• hypertension.

In certain cases, unusual sensations are observed in certain parts of the face. For example, similar manifestations in the language may appear for the reasons listed above, but often have a different etiology. They are provoked by cancer of the tongue and larynx, as well as trauma by a splintered tooth or denture.

Dental procedures cause numbness and other unusual feelings, especially after tooth extraction. Another reason for their appearance may be an uncomfortable position during sleep or an unsuitable pillow. But the sensations caused by such phenomena usually pass soon.

Another group of provoking factors consists of psychogenic and neurogenic disorders.

Causes

Unlike neuritis, neuralgia is not an inflammatory disease. Fever, fever, swelling and other symptoms of the inflammatory process are not associated with this disease. However, if the trigeminal nerve is damaged due to neuritis, pain sensations that fit the description of neuralgia may well occur. To avoid confusion and differentiate the two pathologies, it is necessary to consider their etiology.

The cause of neuritis (like any other inflammatory disease) is viruses and infections that cause gradual destruction of the membrane and nerve trunk, and classical neuralgia in the vast majority of cases occurs due to mechanical effects on the nerve. Today, experts identify dozens of factors that provoke the development of the disease.

Main causes of neuralgia

1. Head injuries leading to changes in the cranial structure and displacement of bones.
2. Benign and malignant tumors that, as they grow, compress the trigeminal nerve.
3. Various bite pathologies and other dental anomalies.
4. Pathologies of the structure and diseases of blood vessels located in close proximity to the nerve (atherosclerosis, aneurysm, vasodilatation, etc.).
5. Sinusitis and otitis in chronic form.
6. Trigeminal neuralgia after tooth extraction. Occurs during a traumatic or incorrectly performed extraction procedure.
7. Damage as a result of infection resulting from a number of diseases: periodontitis, periodontitis, stomatitis, herpes, syphilis.

Trigeminal neuralgia from hypothermia occurs rarely. However, this factor contributes to the development of the disease and complicates treatment. The same can be said about decreased immunity, metabolic disorders, neurosis, diabetes and other complicating factors.

Disorders of facial innervation

A neurotic face may develop due to damage to the nerves that innervate it. Most often these are the trigeminal and facial nerves.

The trigeminal nerve is the 5th pair of cranial nerves. It is the largest of all 12 pairs of these nerve fibers.

N. trigeminus arises symmetrically on both sides of the face and consists of 3 large branches: the ophthalmic, maxillary and mandibular nerves. These three large processes innervate a fairly large area:

• skin of the forehead and temples;
• mucous membrane of the oral and nasal cavities, sinuses;
• tongue, teeth, conjunctiva;
• muscles - chewing, floor of the mouth, palatine, tympanic membrane.

Accordingly, when it is damaged, pathological sensations arise in these elements.

Facial nerve – 7th pair of cranial nerves. Its branches surround the temporal and ocular region, the zygomatic arch, and descend to and behind the lower jaw. They innervate all facial muscles: auricular, orbicularis and zygomatic, chewing, upper lip and corners of the mouth, cheek. As well as the muscles of the lower lip and chin, around the mouth, the muscles of the nose and laughter, and the neck.

N. facialis is also paired, and is located on both sides of the face.

In 94% of cases, the damage to these nerve fibers is unilateral, and only 6% is a bilateral process.

Disruption of innervation can also be primary or secondary.

Primary is the lesion that initially involves the nerve. This could be hypothermia or strangulation.

Secondary damage develops as a consequence of other diseases.

Another reason for the development of facial neurosis is neurogenic and mental disorders. When unpleasant sensations in the face and head occur against the background of psycho-emotional arousal, shock, or as a result of stressful situations.

Symptoms

A common characteristic sign of the disease is immobilization and distortion of part of the face, in which it turns into a sedentary or completely motionless mask. Additional symptoms depend on where the inflammation occurs.

The facial nerve is a paired nerve; when it leaves the brain, it divides into two symmetrical branches. One of them is responsible for the innervation of the right side, and the other is responsible for the innervation of the left side of the face.

As a rule, inflammation affects only one of the two symmetrical parts, so the symptoms of neuritis are almost always unilateral. Contractions of the facial muscles become difficult or impossible, this manifests itself when trying to frown, smile, close an eye or raise an eyebrow. The face becomes distorted and asymmetrical.

The corner of the mouth and the edge of the eye are lowered, the nasolabial fold is smoothed out. When you try to close your eyelids, the eyeball turns upward (Bell's palsy). When you try to close your eyelids, a gap remains between them, this is called lagophthalmos or “hare's eye.”

Since the facial nerve consists primarily of motor fibers, inflammation of the facial nerve results in muscle symptoms. Sensitive, painful symptoms (in the form of neuralgia) are not typical for such neuritis.

However, the common nerve cord includes the intermedius nerve, which consists of sensory fibers and provides the sensation of taste to the outer two-thirds of the tongue, as well as the functioning of the salivary glands. Therefore, with neuritis of the facial nerve, symptoms such as disturbance, partial loss of taste, and increased salivation (drooling) are possible.

Another possible symptom is tear gland dysfunction, dry eye, or watery eyes. A combination of these two symptoms is possible - the so-called “crocodile tears”, when the eye becomes abundantly moisturized when eating, but remains dry the rest of the time (Bogorad syndrome).

Paresis or paralysis of the face usually develops within 24 hours after the appearance of pain behind the ear - the first sign of neuritis. As the disease progresses, symptoms such as hearing loss or intolerance to loud sounds (hyperacusis) are possible.

Ear pain with neuritis can radiate to the back of the head, temple, and be accompanied by loss of coordination, dizziness, and hearing loss. The complex of these symptoms is called Hunt syndrome.

Disruption of the innervation of the external eye muscle with neuritis of the facial nerve is manifested by convergent strabismus. Along with the characteristic signs of inflammatory damage to the facial nerve, symptoms of concomitant diseases may be observed, for example, shooting pain in the ear with otitis media. Or symptoms of cerebrovascular accident due to atherosclerosis.

From the point of view of Tibetan medicine, inflammation of the facial nerve, like other neuritis and neuropathies, refers to disorders of the governing basis Wind (Rlung - Tib.).
This is a light and cold base that has a great influence on other control systems of the body. Its disorder usually manifests itself not only with local symptoms (neuralgia, numbness, paresis, paralysis), but also with metabolic, immune, cardiovascular, respiratory, digestive, excretory, reproductive systems, as well as hormonal regulation.

Sanzhizhapova Avgustina Dondopovna Reflexologist, neurologist Experience 39 years

Facial nerve neurosis

Neuritis (neurosis N. Facialis) or Bell's palsy occurs due to inflammation of the nerve fiber. Reasons leading to this condition:

• pinched nerve as a result of narrowing of the channel through which it passes. This may be a congenital phenomenon or result from inflammation;
• hypothermia;
• other diseases and infections: herpes, mumps, otitis media, stroke, cancer, central nervous system infections;
• injury N. Facialis.

The onset of the disease is usually gradual. Manifested by pain in the behind-the-ear area. After a couple of days, neurological facial symptoms appear:

• smoothing of the nasolabial fold, drooping of the corner of the mouth;
• the face becomes asymmetrical with a skew towards the healthy side;
• eyelids do not droop. When you try to do this, your eye rolls;
• any attempt to show at least some emotion ends in failure, since the patient cannot move his lips, smile, or manipulate his eyebrows. Such manifestations can worsen to the point of paresis and paralysis of the facial muscles, that is, to partial or complete immobility of the affected part of the face;
• taste sensitivity decreases, salivation appears;
• the eyes are dry, but there is lacrimation when eating;
• hearing on the affected side worsens.

The severity of pathological symptoms depends on the degree and area of ​​damage to the nerve fiber. If the disease is treated inadequately, complications may arise in the form of muscle contractures (immobility).

Since the disease is inflammatory in nature, its treatment is aimed at eliminating it. For this, the patient is prescribed hormonal anti-inflammatory drugs - glucocorticoids, as well as decongestants.

Other methods include:

• prescription of vasodilators and analgesics, B vitamins;
• anticholinesterase agents to increase nerve conduction;
• drugs that improve metabolism in nervous tissue;
• physiotherapy;
• massage, exercise therapy in the recovery stage.

And only in extreme cases, when conservative therapy is ineffective, neurosurgical intervention is resorted to.

Pathology

Primary and secondary lesions of the facial nerve

Defeat of L. n. is caused by various reasons and is usually referred to as “neuritis”. There are primary, or idiopathic, and secondary, or symptomatic, neuritis.

The most common neuritis is L. n., called colds or Bell's disease. In etiology, its main role is played by cooling the body, especially the head. Acute development of the disease over several hours or one day is typical. Its pathogenesis is explained by the fact that cooling, which is an allergic factor, causes vascular disorders in the nerve trunk (spasm, ischemia, edema) that disrupt its nutrition and function (ischemic paralysis). The developmental anomaly is also important - the congenital narrowness of the L. n. canal.

Symptomatic neuritis is observed in various inf., toxic diseases, in inflammatory, tumor processes at the base of the brain, in the cerebellopontine angle, in brain stem encephalitis, poliomyelitis, vascular lesions of the brain stem, in fractures of the base of the skull, the pyramid of the temporal bone, in damage to the parotid gland, in acute and more often chronic otitis, during hypertensive crises, etc.

There are cases of congenital paralysis of the muscles innervated by the L. n. (Mobius syndrome), and also describes hereditary and family cases, apparently associated with a genetically determined anomaly of the L. and. channel.

Topical diagnosis of lesions of L. n. is based on its different structure at different levels, therefore, damage to the nerve proximal to the origin of a certain branch causes loss of the corresponding function, and with distal damage, the function is preserved. This is the basis for diagnosing the level of damage along the L. n. canal, where three branches depart from the nerve: the greater petrosal nerve, which supplies fibers to the lacrimal gland, the stapedius nerve, which innervates the stapedius muscle, and the chorda tympani, which provides taste innervation of the anterior 2/3 tongue . Determining the degree of nerve damage is based on identifying the complete or partial loss of its functions and the dynamics of the development of symptoms.

Disturbances in the motor function of the nerve, even with minor damage, can be determined visually by the asymmetry of the face; with complete damage to the nerve, a picture of peripheral paralysis develops: the face is mask-like, the corner of the mouth is lowered, the palpebral fissure is open, the eyebrow is lowered, motionless.

To determine the vegetative function of L. n. examine the functions of tear and salivation. Tear production is examined using the Schirmer test (ribbons of filter or litmus paper are inserted into the lower fornix of the conjunctiva of the eye of the subject, resulting in lacrimation; the intensity of tear production is determined by the length of the paper wetting in millimeters). Salivation is examined by radiometric determination of the concentration ability of the salivary glands and determination of the intensity of salivation by the amount of saliva received (while the subject is sucking a slice of lemon, saliva is collected separately from the pre-catheterized right and left parotid ducts for 1 minute). The study of taste sensitivity on the anterior 2/3 of the tongue is carried out using a chemical method. gustometry, in which the thresholds of the main taste sensations are determined - sweet, salty, sour and bitter by applying the appropriate solutions to the tongue, or electrogustometry, when the threshold values ​​​​of the strength of the electric current are determined, causing a specific sensation of sour when it irritates the taste buds of the tongue (see Taste).

Rice. 2. A patient with symptoms of neuritis of the left facial nerve: 1 - facial asymmetry; 2 - smoothness of the nasolabial fold and increased asymmetry when teeth are bared; 3 - lagophthalmos, the eyeball is raised upward and retracted outwards (Bell's symptom); 4 - asymmetry of the frontal folds when raising the eyebrows.

The main symptoms of neuritis L. n. (Fig. 2) are caused by peripheral paresis, paralysis of the facial muscles of the upper and lower half of the face (prosopoplegia) on the side of the affected nerve. Already at rest, the mask-like appearance of the corresponding half of the face (the face of the sphinx) attracts attention - the eye is wide open, almost does not blink, the forehead is without wrinkles, the nasolabial fold is smoothed, the eyebrow and corner of the mouth are lowered. The patient cannot frown, raise his eyebrows, when closing his eyes the eyelids do not close completely, the palpebral fissure gapes (lagophthalmos), when trying to close the eye, the eyeball rises upward and deviates outward (Bell's phenomenon), while the sclera is not completely covered. When smiling or laughing, half of the face is motionless; when teeth are shown, the mouth deviates to the healthy side; when the cheeks are puffed out, the diseased side “sails.” While eating, food gets stuck between the cheek and teeth, saliva and liquid food are poorly retained in the mouth, the patient cannot spit or whistle. During the acute period, the patient clearly pronounces labial sounds (b, m). Due to the slight displacement of the mouth, the protruding tongue may deviate slightly in the healthy direction. Often, motor disturbances appear simultaneously with movement disorders, and sometimes they are preceded by usually mild and short-lived pain in the area of ​​the mastoid process and the auricle. Other disorders may also be observed due to damage to the sweat-salivary and taste fibers of the nerve trunk, extending in the L. n. canal. at its different levels. When L. is affected and. in the canal above the origin of the greater petrosal nerve, in addition to paralysis of the facial muscles, there is a lack of lacrimation (dry eye), sweating (dry skin of half the face), unilateral loss of taste in the anterior 2/3 of the tongue, strong, unpleasant perception of ordinary sounds (hyperacusis). With damage below the origin of the petrosal nerve, increased lacrimation is observed, because due to the weakness of the lower eyelid, tears do not enter the lacrimal canal, but flow out; taste disorder and hyperacusis. With a lesion below the stapedial nerve, hyperacusis does not occur; with a lesion below the origin of the chorda tympani, the disorders noted above are absent, but lacrimation persists. When L. is affected. at the level of the geniculate node, Hunt's syndrome is observed - a combination of peripheral paralysis with herpetic rashes and excruciating pain in the area of ​​the auricle, tympanum, back of the palate and the anterior half of the tongue (see Hunt's syndrome). Colds neuritis L. and. sometimes it can be bilateral (diplegia facialis).

An important diagnostic and prognostic value is the study of electrical excitability of the nerve, in which a partial or complete reaction of degeneration is detected, and complete is a prognostically unfavorable sign. An electromyographic study makes it possible to judge the speed of impulse conduction in the left leg. and its branches and the presence of nuclear destruction.

Peripheral muscle paralysis when L. is affected and. should be distinguished from central paralysis associated with damage to the supranuclear tracts, in which the electrical excitability of L. n. not qualitatively changed.

In diagnosis, purely wedge and signs are also important. With L.'s disease. the upper and lower groups of facial muscles are involved to the same extent. With central paralysis, the muscles of the lower half of the face suffer significantly more; paralysis of the muscles of the upper facial group is almost absent. The muscles of the upper parts of the face are innervated from that part of the nucleus of the facial nerve, which receives bilateral supranuclear (corticonuclear) pathways.

In most cases, the course and prognosis of primary neuritis L. and. favorable. Mild cases are observed with complete restoration of facial movements within 2-3 weeks, moderate cases last approx. 2 months, sometimes recovery occurs only after 5-6 months. First, the function of the muscles of the upper half of the face is restored, then the lower half. Complete restoration of facial muscles is observed in approximately 70% of cases. Some patients develop contractures of paretic muscles. On the diseased side, the palpebral fissure narrows, the corner of the mouth is pulled up, and on the healthy side, the nasolabial fold is smoothed out. During the study, it is established that the affected side is the one on which differentiated movements are difficult. Patol and synkinesis are observed. When smiling, laughing, or showing teeth, an even greater narrowing of the palpebral fissure occurs at the same time, the eye may close, and when closing the eyes, the corner of the mouth tightens. Tic twitching of the corners of the mouth, orbicularis oculi muscle, and cheeks appears. Mild synkinesis and isolated tic-like twitches may persist after complete restoration of the function of the facial muscles. Recurrences of catarrhal neuritis L. are possible. both on the same and on the other side. They are rare and in some cases they are more severe, in others they are milder than the initial disease.

Paralysis of the facial muscles is not difficult to establish; it is more difficult to differentiate primary neuritis of L. n. from secondary. Combined lesion of L. n. and other cranial nerves, pyramidal and other conduction disorders indicates the secondary nature of the disease. In all cases of neuritis L. n. An otological examination should be performed. Otitis, especially chronic ones, may be accompanied by damage to L. n. in the channel. Primary neuritis may be indicated by the acute development of the disease, its occurrence in connection with cooling, in some cases after a sore throat or flu. To identify early signs of contractures, a study of the state of electrical excitability of the affected nerve is carried out (see Electrodiagnostics).

Facial nerve damage

There are damages to L. n. for fractures of the base of the skull, wounds of the parotid region, surgical interventions on the ear, salivary gland and total removal of acoustic neuromas. In case of fractures of the base of the skull, the nerve is damaged at the junction of the horizontal section of the LN canal. to vertical. The degree of nerve damage varies. When a nerve ruptures, early paralysis of the facial muscles develops; when the nerve swells or the blood circulation in it is disrupted, late paralysis develops, appearing 10-14 days after the injury.

During ear surgeries, nerve damage can be primary or secondary, when the nerve is compressed by bone fragments or hematoma; open - when the integrity of the L. n. channel is violated. and closed. During operations on the parotid gland or injuries to this area, the extracranial part of the nerve distal to the stylomastoid process is damaged. With total removal of acoustic neuromas of the L. n. is damaged along the path from the brain stem to the internal auditory canal.

Trigeminal neuralgia

This is another lesion of the nerve fiber structure, which is often chronic and accompanied by periods of exacerbation and remission.
It has several causes, which are divided into idiopathic - when a nerve is pinched, and symptomatic.

The main symptom of neuralgia is paroxysmal sensations in the form of pain on the face and in the mouth.

Pain sensations have characteristic differences. They are “shooting” and resemble an electric shock; they arise in those parts that are innervated by the n.trigeminus. Having appeared once in one place, they do not change localization, but spread to other areas, each time following a clear, monotonous trajectory.

The nature of the pain is paroxysmal, lasting up to 2 minutes. At its height, a muscle tic is observed, that is, small twitching of the facial muscles. At this moment, the patient has a peculiar appearance: he seems to freeze, but does not cry, does not scream, and his face is not distorted from pain. He tries to make a minimum of movements, since any of them increases the pain. After the attack there is a period of calm.

Such a person performs the act of chewing only with the healthy side, at any time. Because of this, compaction or muscle atrophy develops in the affected area.

The symptoms of the disease are quite specific, and its diagnosis is not difficult.

Therapy for neuralgia begins with taking anticonvulsants, which form its basis. Their dose is subject to strict regulation and is prescribed according to a specific scheme. Representatives of this pharmacological group can reduce agitation and the degree of sensitivity to painful stimuli. And, therefore, reduce pain. Thanks to this, patients have the opportunity to freely eat and talk.

Physiotherapy is also used. If this treatment does not give the desired result, proceed to surgery.

Clinical picture

The symptoms are so characteristic that in a typical case the diagnosis is not difficult. The disease begins acutely, most often with pain behind the ear. Gradually the pain spreads across the face and to the back of the head. On the affected side, tears begin to flow from the eye, but sometimes dryness appears. Some patients notice that ordinary sounds have become extremely unpleasant. Over the course of 1-2 days, the symptoms increase, and paresis (weakness) or paralysis of the facial muscles occurs.

Manifestations of damage are:

• on the affected side of the face all skin folds are smoothed, this is especially visible on the nasolabial fold;
• when pronouncing consonants or at the moment of exhalation, swelling of the cheek is visible (symptom of “sail”);
• when you try to close your eyes, the eyelid on the affected side does not close, and the eyeball itself turns outward and upward - this characteristic symptom is called “hare’s eye” or lagophthalmos;
• When eating, solid food is between the gum and cheek, and liquid flows out of the corner of the mouth.

Real life examples

Some famous people, whose fame sometimes trumpets all over the world, were also hostage to the pathology of the facial nerve.

Sylvester Stallone, who is known for his enchanting roles, was injured at birth. The actor's mother had a difficult birth and he had to be pulled with forceps. The result is damage to the vocal cords and paresis of the left side of the face. Because of this, Stallone had problems with speech, which became a reason for ridicule from his peers.

The actor grew up as a difficult child. But, in spite of everything, he managed to overcome his defect and achieve considerable success, although partial immobility of his face remained.

Domestic showman Dmitry Nagiyev received facial asymmetry, which was nicknamed “Nagiyev’s squint”, due to paresis of the facial nerve. The illness happened unexpectedly. As a theater student, one day he felt that his face was not moving.

He spent 1.5 months in the hospital to no avail. But one day in his room a window broke due to a draft. Fright provoked a partial return of mobility and sensitivity of the facial part, but the left part retained its immobility.

Diagnosis of inflammation of the facial nerve

If the doctor is properly qualified, then only based on the patient’s complaints will he be able to make a diagnosis and identify the severity of the pathological process. But even if the clinical picture is typical, the patient will have to undergo a series of diagnostic examinations:

• take blood and urine tests;
• undergo magnetic resonance imaging;
• do electroneurography.

The results obtained will help determine what treatment for inflammation of the facial nerve will be. In addition, such an examination will allow the doctor to identify the body’s perception of non-steroidal anti-inflammatory drugs - these are the drugs that will be used for therapy.

Migraine

This condition is accompanied by attacks of unbearable headache. It is also associated with disruption of the trigeminal nerve, or more precisely, with its irritation in one part of the head. This is where the pain is subsequently localized.

The onset of migraine includes several stages:

• initial;
• aura;
• painful;
• final one.

Paresthesia of the head and face appears with the development of the aura stage. In this case, the patient is bothered by a feeling of tingling and crawling, which occurs in the arm and gradually moves to the neck and head. The person’s face becomes numb and it becomes difficult for him to speak. I am concerned about dizziness and visual disturbances in the form of light flashes, floaters and a decrease in the field of vision.

Facial paresthesia is a precursor to migraine, but often the attack occurs without the aura stage.

Symptoms of inflammation of the trigeminal nerve

Neuritis of the branches of the trigeminal nerve, as a rule, does not affect all three processes. Most often, inflammation is observed in the peripheral areas of one of the branches, most often the maxillary (inflammation of the trigeminal nerve of the jaw). That is why the main manifestation of neuritis (pain) is most clearly observed during food intake and hygiene procedures. Below are the main signs of inflammation of the trigeminal nerve.

Symptoms of trigeminal neuritis

1. Pain due to inflammation of the trigeminal nerve.
   With neuritis, pain occurs in the place where the nerve process passes. Usually it is quite acute and pronounced, but with an extensive inflammatory process, prolonged attacks of aching pain can be observed, covering large areas (chronic inflammation of the trigeminal nerve).
2. Impaired functionality of the facial muscles.
   Signs of inflammation of the trigeminal nerve on the face are observed due to the fact that the trigeminal nerve contains both motor and sensory fibers. Inflammation of the trigeminal nerve branch can be manifested by disruption of the facial muscles (decreased sensitivity and muscle atrophy in the later stages of the disease).
3. Temperature and other signs.
   With neuritis, it is also possible to increase salivation, lacrimation, dullness of auditory and visual reflexes, impaired taste, and so on. These manifestations of neuritis occur individually and are associated with the form and severity of the disease. The temperature during inflammation of the trigeminal nerve often exceeds normal values, but only slightly.

Psychogenic causes of facial neurosis

Undoubtedly, disturbances in facial sensations quite often become a consequence of pathology of internal organs and blood vessels.

But often they are caused by psychological disorders and pathological thoughts that arise in our heads.

Facial paresthesias can be situational in nature and develop during episodic nervous excitement: as a result of quarrels, prolonged and intense screams. Such phenomena cause overstrain of the muscles, especially the cheeks and those located around the mouth. As a result, we experience facial numbness and even mild soreness.

The feeling of fear causes us to breathe quickly and shallowly, or to hold our breath. Disturbances in the respiratory rhythm can also provoke impressions that are atypical for us. A feeling arises that is characterized as a “chill running through.” Moreover, it is more concentrated at the roots of the hair. In this case they say: “chills to the marrow of the bones.” The face also becomes cold, a slight tingling appears in its area.

Such phenomena are disturbing when we are overwhelmed by strong emotions. But they accompany people suffering from mental disorders systematically.

A special type of neurotic facial manifestations is a nervous tic. It is characterized as an uncontrolled and systematic contraction of the facial muscles.

The disorder more often accompanies men. And it manifests itself with the following symptoms:

1.Motor:

• frequent blinking, winking;
• setting the lips with a tube;
• nodding head;
• constant spitting or sniffing;
• opening or upturning of the corner of the mouth;
• wrinkling of the nose.

2. Vocal:

• screaming;
• grunt;
• coughing;
• repetition of words.

There are also signs – precursors – that signal the appearance of a tic.
These include itching, facial heat and other paresthesias. Naturally, these signs are considered pathological if they occur in an inappropriate situation. It happens that only the patient himself feels them, but they are not visible to others.

But often twitching and other nervous symptoms become noticeable by other people, and they cause a lot of discomfort to the patient.

Tics can be simple, when there is only one symptom, or complex, which combines several manifestations.

The most common, main cause of tics is mental stress. It can be caused by a strong stress factor of one-stage action. Perhaps you were very scared of something, or broke up with your loved one. That is, the shock was so strong for you that your nervous system lost control.

Or, on the contrary, disorders develop as a result of prolonged monotonous exposure. Symptoms often appear due to lack of sleep and overwork.

Their duration varies. A situational nervous tic disappears a few hours or days after the cause is eliminated. In another case, it persists for years or haunts the patient throughout his life. In such a situation, in addition to eliminating the provoking factor, subsequent psychological work with the patient is required. This type of disorder is called chronic.

A nervous tic can be one of the signs of mental disorders such as neurosis, obsessive thoughts and phobias, depression.

Another group of provoking factors include:

• diseases - stroke, brain injury, infections or poisons;
• neurodegenerative diseases - Huntington's chorea. Characterized by destruction of brain tissue. Accompanied by uncoordinated, sudden movements, as well as neurological disorders of the face. Of these, the first sign is slow eye movements. Then a muscle spasm of the face occurs, which manifests itself in grotesque facial expressions - grimacing. Speech, chewing and swallowing are impaired;
• burdened heredity;
• parasitic infestations;
• eye fatigue due to prolonged eye strain;
• unbalanced diet, when the body receives little magnesium, calcium, glycine. These elements participate in the normal conduction of nerve impulses and are responsible for the coordinated functioning of the nervous system.

Nervous tics in children

There are several types of such disorders in childhood.

Transient tic disorder begins to manifest itself during early school age. Its duration ranges from 1 month to 1 year. Motor types of tics occur more often. Mainly typical for children with developmental delays and autism.

Chronic disorder occurs before age 18. And lasts from 1 year and above. In this case, either motor or vocal tics develop. The earlier the pathological symptoms appear, the easier and faster they pass.

Tourette syndrome is a multiple tic disorder characterized by both motor and movement types. A serious disease, which, however, softens with age.

A special type of disease, which is also characterized by signs of the nervous type, is minor chorea. It develops against the background of infections caused by streptococcus: sore throat, tonsillitis, rheumatism. Accompanied by pathological changes in nervous tissue.

Along with hyperkinesis, emotional instability, irritation, restlessness and anxiety, this condition corresponds to neurotic changes in the face. They are expressed in tension and spasms of the facial muscles, which is often mistaken for grimacing. There is also a spasm of the larynx, manifested in inappropriate screams.

At school, such children, not knowing the true cause of facial hyperkinesis, and even in combination with increased activity, are reprimanded and kicked out of class. Such an attitude towards the child forces him to miss school classes and avoid going to school. Treatment for chorea minor, along with sedatives, includes antibiotics to fight infection and anti-inflammatory drugs.

A nervous tic leaves a heavier imprint on a child’s psyche than on an adult. It often causes anxiety and detachment, withdrawal, and even provokes depressive disorders. Causes sleep disturbances, speech difficulties, and learning difficulties.

Tic disorders lead to distorted self-perception and decreased self-esteem.

Parents of such children are advised not to focus the child’s attention on the problem. On the contrary, they recommend finding ways to shift attention and increase self-esteem. A special place is given to support groups for such people and communication in general.

How to get rid of nervous tics

In order to free yourself from unpleasant sensations, you must first eliminate their problem. Sometimes all it takes is a good night's sleep. In another case, you need to change the situation for a while, get out of the destructive environment.

Among the auxiliary methods used are herbal soothing teas, baths with the addition of aromatic oils, swimming, walks in the fresh air or sports: running, yoga.

Add ingredients with a high content of calcium and magnesium to your menu. These include fermented milk products, buckwheat, bran bread, red fish, eggs, and meat. Vegetables and fruits include beets, currants, dried fruits, nuts and parsley.

If these foods do not fit into your diet, consider taking appropriate vitamin supplements. Do not overuse strong tea and coffee.

And most importantly: remain optimistic and calm in any situation!

In cases where the condition worsens, psychotherapy is sought. Cognitive behavioral therapy is especially effective in helping to stop tic disorders at the stage of their precursors.

Habit reversal therapy teaches patients movements that help prevent the development of neurological facial symptoms.

Medications include anticonvulsants and muscle relaxants, Botox injections, and antidepressants.

If the above methods are ineffective in combating nervous tics, they turn to deep brain stimulation. A device is installed in the GM that controls electrical impulses.

How to remove teak yourself

If a nervous facial tic is situational and is not too intense, but at the same time obsessive, you can try to get rid of it using physical methods.

One way is to try to disrupt the pathological muscle rhythm by overexerting it. For example, if your eye twitches, try to close your eyes tightly.

It is possible to calm an overexcited muscle through a light massage. Or apply cold to it. The temperature difference will also help. Wash your face alternately with cold and warm water.

Dermatillomania

Neurosis of the face and scalp can manifest itself in a behavioral disorder such as dermatillomania.

Its main manifestation is scratching the skin of the face and head, not because of itching, but because of dissatisfaction with its appearance. This also includes an obsessive zeal to squeeze out pimples, scratch off scabs, and pull out hair. Self-injurious actions cause a short-term feeling of pleasure, followed by feelings of shame, frustration, and dissatisfaction.

The face of such patients is covered with scars and scars due to constant trauma to the skin. This process is uncontrollable and can occur at any time of the day. But most often traumatic actions are carried out in front of a mirror.

Symptoms of the disorder also include the habit of biting the lips and mucous membranes of the cheeks. Patients are not deterred by the prospect of redness, bleeding, and scarring of the skin. They repeat the ritual day after day. It lasts from a few minutes to an hour.

Such actions can be provoked by feelings of fear, anxiety, and close examination of one’s skin because there is nothing to do.

Dermatillomania has been described as a state of addiction. It begins with concentrating on what the patient thinks is a skin defect. Gradually, attention is increasingly focused on this detail. A person begins to think that he is sick with something serious. This provokes irritability and nervousness in him, leading to obsessive actions.

The root cause of the disease is rooted in the psychological state of a person and lies in self-dissatisfaction, anger, feelings of shame and malice. Traumatic rituals are a way of punishment, self-flagellation.

Treatment of this pathology requires the intervention of a psychotherapist and a dermatologist.

The main method of treating addiction is psychotherapy, in particular cognitive behavioral therapy.

Yoga, physical exercise, relaxation procedures, as well as any hobby that absorbs a person and helps redirect attention will help reduce anxiety, distract and relax.

The help of a dermatologist is necessary to eliminate skin lesions in order to prevent infection and reduce the degree of dermatological defect.

Neuroses

This is a large group of diseases, manifested primarily in psycho-emotional disorders, as well as malfunctions of the autonomic nervous system. They do not cause pathological disorders of the nervous tissue, but have a significant impact on the human psyche.

There are several types of disorders in which the symptoms are visible.

Muscular neurosis is manifested by muscle tension, spasm and convulsive twitching. Neurosis of the facial muscles makes itself felt with the following manifestations:

• nervous tic;
• lip tension, clenching;
• convulsive contraction, the face seemed to move;
• tingling, burning sensation;
• muscle pain;
• Tension of the neck muscles is manifested by a feeling of lack of air, a lump in the throat.

When we find ourselves in a stressful situation, our body produces stress hormones. They, among many other reactions, cause muscle tension. Now imagine, if we are exposed to chronic stress, what happens to our muscles, and specifically to the muscles of the face. Being systematically in hypertonicity, they overexert themselves. This is what causes their nervous twitching, spasms, and convulsions.

Another type of neurosis is skin. It causes paresthesias in the facial skin of the following type:

• severe itching, burning in the facial and scalp without clear localization;
• sensation as if something were touching the face. And it's terribly annoying;
• the appearance of red spots on the face and neck. Possible rash.

The causes of such phenomena are nervous and mental overstrain, chronic stress, sleep disturbances, as well as disruptions in hormonal regulation.

With neuroses associated with disruption of the autonomic nervous system, various manifestations may also occur. Malfunctions in the functioning of the vascular network occur, and a vascular neurotic disorder develops.

Vascular neurosis of the face is manifested by flaking and dryness, a feeling of tightness of the skin. She becomes pale, sometimes cyanotic, and her sensitivity worsens. In addition, sneezing appears, the nose is stuffy, the eyes become red and watery, the skin itches and itches. This indicates the development of vegetative-allergic reactions.

Causes of inflammation of the trigeminal nerve

Diagnosing trigeminal nerve inflammation can take quite a long time, given the number of procedures, tests and specialists that need to be seen. X-ray, computed tomography, electroneurography, electromyography, as well as urine and blood tests are the most common procedures when diagnosing inflammation of the trigeminal nerve. As for the direct causes of neuritis, for greater clarity they can be divided into several classes.

Causes of trigeminal neuritis

• Infectious diseases.
  Often neuritis occurs against the background of tuberculosis, syphilis and influenza. Neuritis can be triggered by chronic inflammatory diseases, allergic reactions, as well as tumors in the brain that compress the nerve.
• Injuries and mechanical damage.
  Traumatic trigeminal neuritis is most often associated with damage to the jaws or base of the skull, in which the nerve trunk is damaged or torn.
• Dental factors.
  Advanced pulpitis, periodontitis, cysts and other dental diseases characterized by an inflammatory process can provoke the development of neuritis. Doctors separately distinguish dental traumatic neuritis. This is trigeminal neuritis after tooth extraction, improper dentures and implantation, as well as after other dental procedures that were carried out with errors.
• Other factors.
  These include, first of all, hypothermia, poisoning, as well as decreased immunity and disruption of the functionality of body systems.